Individual
BRIANA TERESA COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1819 CLINCH AVE STE 108, KNOXVILLE, TN 37916-2435
(865) 546-5111
Mailing address
1819 CLINCH AVE STE 108, KNOXVILLE, TN 37916-2435
(865) 546-5111
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
69990
TN
207RI0011X
Interventional Cardiology Physician
Primary
69990
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q093025
—
TN
Enumeration date
05/31/2013
Last updated
08/16/2024
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